Maiorana Carlo, Poli Pier Paolo, Deflorian Matteo, Testori Tiziano, Mandelli Federico, Nagursky Heiner, Vinci Raffaele
Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, IRCCS Cà Granda Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy.
Section of Implant Dentistry and Oral Rehabilitation, Department of Biomedical, Surgical and Dental Sciences, Dental Clinic, IRCCS Galeazzi Orthopedic Institute, University of Milan, Milan, Italy.
J Periodontal Implant Sci. 2017 Aug;47(4):194-210. doi: 10.5051/jpis.2017.47.4.194. Epub 2017 Aug 11.
The aim of the present study was to evaluate the healing of post-extraction sockets following alveolar ridge preservation clinically, radiologically, and histologically.
Overall, 7 extraction sockets in 7 patients were grafted with demineralised bovine bone mineral and covered with a porcine-derived non-crosslinked collagen matrix (CM). Soft tissue healing was clinically evaluated on the basis of a specific healing index. Horizontal and vertical ridge dimensional changes were assessed clinically and radiographically at baseline and 6 months after implant placement. For histological and histomorphometric analysis, bone biopsies were harvested from the augmented sites during implant surgery 6 months after the socket preservation procedure.
Clinically, healing proceeded uneventfully in all the sockets. A trend towards reduced horizontal and vertical socket dimensions was observed from baseline to the final examination. The mean width and height of resorption were 1.21 mm (=0.005) and 0.46 mm (=0.004), respectively. Histologically, residual xenograft particles (31.97%±3.52%) were surrounded by either newly formed bone (16.02%±7.06%) or connective tissue (50.67%±8.42%) without fibrous encapsulation. The CM underwent a physiological substitution process in favour of well-vascularised collagen-rich connective tissue.
Socket preservation using demineralised bovine bone mineral in combination with CM provided stable dimensional changes of the alveolar ridge associated with good re-epithelialisation of the soft tissues during a 6-month healing period.
本研究旨在通过临床、影像学和组织学方法评估牙槽嵴保存术后拔牙窝的愈合情况。
总共7名患者的7个拔牙窝植入脱矿牛骨矿物质，并覆盖猪源非交联胶原基质（CM）。根据特定的愈合指数对软组织愈合情况进行临床评估。在种植体植入前的基线以及植入后6个月，通过临床和影像学方法评估牙槽嵴的水平和垂直尺寸变化。在拔牙窝保存手术6个月后的种植手术过程中，从植骨部位获取骨活检样本，用于组织学和组织形态计量学分析。
临床上，所有拔牙窝的愈合过程均顺利。从基线到最终检查，观察到拔牙窝的水平和垂直尺寸有减小的趋势。吸收的平均宽度和高度分别为1.21毫米（=0.005）和0.46毫米（=0.004）。组织学上，残留的异种移植颗粒（31.97%±3.52%）被新形成的骨组织（16.02%±7.06%）或结缔组织（50.67%±8.42%）包围，无纤维包裹。CM经历了生理替代过程，有利于形成血管丰富的富含胶原的结缔组织。
使用脱矿牛骨矿物质联合CM进行拔牙窝保存，在6个月的愈合期内，牙槽嵴尺寸变化稳定，软组织再上皮化良好。
